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New Future for Behavioral Health Care—Where Are We Headed?

January 10, 2014

The health care community has long-struggled to find the best way to effectively care for behavioral health patients. Early in my tenure, I spoke with hospital leaders who were providing extensive uncompensated care to patients with mental illness.

In some cases, these patients languished for months in an inpatient setting because they had nowhere to go. But without this safety net, where would these individuals receive any type of care?

Currently, about one in four adult Americans suffer from a mental illness each year. Many are negatively impacted by a fragmented system, insufficient funding for services, too few providers, restricted insurance coverage, and personal financial barriers.

According to the U.S. Department of Health and Human Services, in 2012, there were 5.4 million adults suffering from a mental illness who did not receive any mental health services. Several reasons were reported, including:

  • Inability to afford the cost of care (45.7%) 
  • Not knowing where to go for services (22.8%)

Now, more than ever, we have an opportunity to improve the quality of these lives through greater access to better coordinated care.

Beginning in 2014, mental health and substance abuse services are classified among the ten “Essential Health Benefits” under the Affordable Care Act. The new health insurance marketplaces cannot apply yearly or lifetime dollar limits on coverage of these benefits. Nor can insurers deny anyone coverage or charge more for pre-existing conditions.

The Affordable Care Act supports new health care delivery models that will better serve behavioral health patients by coordinating and managing all health care needs of an individual.

Payment incentives will encourage providers to better manage patients’ transitions among care settings.

There are new standards for the quality of behavioral health care.

Across the country, there is recognition that we cannot separate behavioral and medical health care. The “mind-body” linkage is critical. Behavioral health conditions exacerbate physical illnesses, and physical illnesses worsen behavioral disorders.

In 2013, Pennsylvania’s Department of Public Welfare’s Office of Mental Health and Substance Abuse Services (OMHSAS) held statewide forums on behavioral and physical health integration. There are plans for more in 2014.   

OHMSAS wants to assure that the system is person- and family-centered. HAP has been engaged in several related discussions, helping to provide guidance to the state on strategic planning.

The association is advocating for the use of advanced practice professionals to practice more fully in the behavioral health care setting to preserve access in high-utilization and under-served areas.

We are working with behavioral health navigators to assist hospitals with outreach and enrollment to get coverage for uninsured behavioral health constituents. And the Delaware Valley Healthcare Council of HAP serves on the new Community Behavioral Health Kitchen Cabinet to improve care delivery in the southeast.

As we work to improve access to care for patients with mental illness, we must add behavioral and physical health integration to the list. I look forward to being part of this important discussion.





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